New Directions and Trends in Interventional Cardiology
New Directions and Trends in Interventional Cardiology
Insights from the TCT and AHA 2024 Conferences
“Interview with Dr. George D. Dangas, President of SCAI and Director of TCT”. Dave Fornell | January 23, 2025 |
Key Trends in Interventional Cardiology:
1. Advancements in Structural Heart Interventions
• Expansion beyond TAVR to include mitral and tricuspid valve repair/replacement.
• Recent FDA approvals for tricuspid valve replacement and clipping devices.
• Growing adoption of transcatheter procedures to reduce the need for open-heart surgery.
2. The Role of CCTA in Pre-Procedure Planning
• Coronary Computed Tomography Angiography (CCTA) is improving diagnosis and procedural planning.
• Helps identify plaque characteristics, vessel anatomy, and pre-plan PCI strategies.
• Reduces the need for unnecessary diagnostic catheterizations.
3. Shift at TCT from stents and PCI to structural heart interventions.
• Discussed at AHA 2024, focusing on the integration of new imaging and intervention techniques.
4. Shorter Dual Antiplatelet Therapy (DAPT) Duration
• Significant reduction in DAPT duration from multi-year regimens to 1-3 months.
• Benefits include reduced bleeding risks, better patient compliance, and lower healthcare costs.
5. The Renaissance of Bioresorbable Stents
• New developments in bioresorbable vascular scaffolds (BVS) after initial setbacks.
• Abbott’s Esprit BTK scaffold successfully redeveloped for peripheral artery disease (PAD).
6. Hybrid Interventional Approaches
• Growing emphasis on combining coronary and structural interventions in a single procedure.
• Clinical trials now exploring integrated treatment strategies for valve and coronary disease.
7. The Rise of AI in Interventional Cardiology
• FDA-approved AI algorithms now enhance CCTA analysis and pre-procedure planning.
• AI assists in identifying vulnerable plaques, quantifying coronary tree anatomy, and performing virtual FFR assessments.
• Enables more precise vessel sizing and procedural planning before entering the cath lab.
8. Increasing Use of Intravascular Imaging
• IVUS and OCT improve PCI outcomes but face barriers due to cost and procedure time.
• Despite limitations, studies confirm their role in optimizing complex interventions.
• CCTA is emerging as an alternative imaging tool due to its ability to assess arterial remodeling more clearly.
Conclusion:
Interventional cardiology is undergoing a major transformation, with structural heart innovations, AI integration, and imaging advancements shaping the field. The TCT and AHA conferences highlight the importance of these developments, emphasizing precision medicine, procedural efficiency, and patient-centered approaches. Future research will likely focus on optimizing hybrid procedures, refining AI-driven diagnostics, and expanding non-invasive interventions.
